Bilateral Simultaneous Anterior Ischemic Optic Neuropathy following Total Knee Arthroplasty with Epidural Block

Ischemic optic neuropathy (ION) resulting in perioperative vision loss (POVL) is a rare occurrence following nonocular procedures. Bilateral simultaneous anterior ION (AION) is even rarer, and no cases have been reported after central neuraxial block. We report a case of bilateral simultaneous AION,...

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Main Authors: Ahmed M. Habib, Yousef A. Fouad, Mahmood O. Mekkawy
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Ophthalmological Medicine
Online Access:http://dx.doi.org/10.1155/2021/9952500
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author Ahmed M. Habib
Yousef A. Fouad
Mahmood O. Mekkawy
author_facet Ahmed M. Habib
Yousef A. Fouad
Mahmood O. Mekkawy
author_sort Ahmed M. Habib
collection DOAJ
description Ischemic optic neuropathy (ION) resulting in perioperative vision loss (POVL) is a rare occurrence following nonocular procedures. Bilateral simultaneous anterior ION (AION) is even rarer, and no cases have been reported after central neuraxial block. We report a case of bilateral simultaneous AION, confirmed by multimodal imaging, in a 66-year-old male patient who underwent total knee arthroplasty under epidural anesthesia in which episodes of hypotension—one intraoperatively and one late postoperatively—had occurred. Hypotension is the most common adverse effect to epidural block, and counseling about POVL should extend beyond general anesthesia to include those undergoing procedures with central neuraxial block.
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series Case Reports in Ophthalmological Medicine
spelling doaj-art-bef01d79620141fbbb5f3623965d99202025-08-20T02:18:59ZengWileyCase Reports in Ophthalmological Medicine2090-67222090-67302021-01-01202110.1155/2021/99525009952500Bilateral Simultaneous Anterior Ischemic Optic Neuropathy following Total Knee Arthroplasty with Epidural BlockAhmed M. Habib0Yousef A. Fouad1Mahmood O. Mekkawy2Al Mashreq Eye Center, Cairo, EgyptAl Mashreq Eye Center, Cairo, EgyptAl Mashreq Eye Center, Cairo, EgyptIschemic optic neuropathy (ION) resulting in perioperative vision loss (POVL) is a rare occurrence following nonocular procedures. Bilateral simultaneous anterior ION (AION) is even rarer, and no cases have been reported after central neuraxial block. We report a case of bilateral simultaneous AION, confirmed by multimodal imaging, in a 66-year-old male patient who underwent total knee arthroplasty under epidural anesthesia in which episodes of hypotension—one intraoperatively and one late postoperatively—had occurred. Hypotension is the most common adverse effect to epidural block, and counseling about POVL should extend beyond general anesthesia to include those undergoing procedures with central neuraxial block.http://dx.doi.org/10.1155/2021/9952500
spellingShingle Ahmed M. Habib
Yousef A. Fouad
Mahmood O. Mekkawy
Bilateral Simultaneous Anterior Ischemic Optic Neuropathy following Total Knee Arthroplasty with Epidural Block
Case Reports in Ophthalmological Medicine
title Bilateral Simultaneous Anterior Ischemic Optic Neuropathy following Total Knee Arthroplasty with Epidural Block
title_full Bilateral Simultaneous Anterior Ischemic Optic Neuropathy following Total Knee Arthroplasty with Epidural Block
title_fullStr Bilateral Simultaneous Anterior Ischemic Optic Neuropathy following Total Knee Arthroplasty with Epidural Block
title_full_unstemmed Bilateral Simultaneous Anterior Ischemic Optic Neuropathy following Total Knee Arthroplasty with Epidural Block
title_short Bilateral Simultaneous Anterior Ischemic Optic Neuropathy following Total Knee Arthroplasty with Epidural Block
title_sort bilateral simultaneous anterior ischemic optic neuropathy following total knee arthroplasty with epidural block
url http://dx.doi.org/10.1155/2021/9952500
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AT yousefafouad bilateralsimultaneousanteriorischemicopticneuropathyfollowingtotalkneearthroplastywithepiduralblock
AT mahmoodomekkawy bilateralsimultaneousanteriorischemicopticneuropathyfollowingtotalkneearthroplastywithepiduralblock